Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Arthroscopy. 2018 Apr;34(4):1054-1059. doi: 10.1016/j.arthro.2017.10.039. Epub 2018 Jan 2.
To compare the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction in young and middle-aged Asians.
A retrospective study was performed using prospectively collected data from a tertiary institution ACL registry. All Asian patients with ACL tears who underwent primary arthroscopic ACL reconstruction by a single surgeon between 2008 and 2014, with minimum 2-year follow-up, were included. Patients with previous knee surgery or multiligamentous knee injuries were excluded. Two groups were formed: young patients (YP) (age <30) and middle-aged patients (MP) (age >40). They were compared preoperatively and 6 months, 1 year, and 2 years postoperatively for demographics, knee range of motion, anterior laxity, Tegner level, Lysholm and International Knee Documentation Committee grade, ability to return to preinjury level of activity, and patient satisfaction.
YP (n = 84) and MP (n = 22) had differences in mean age (YP = 23.1 years, range 18-29 years; MP = 46.4 years, range 41-59 years, P < .001), preinjury Tegner level (YP = 7.4, MP = 6.4, P = .005), and preoperative Lysholm scores (YP = 65.3, MP = 53.0, P = .034). The incidence of meniscal and chondral injuries was similar. Two years postoperatively, both groups had comparable knee range of motion and anterior laxity. The Tegner score was different (YP = 6.3, MP = 5.2, P = .028), but the proportion of patients returning to preinjury Tegner level (YP = 45.2%, MP = 46.9%, P = .812), Lysholm scores (YP = 92.5, MP = 93.8, P = .794), proportion of patients with knees rated International Knee Documentation Committee A/B (YP = 77.4%, MP = 81.8%, P = .777), and satisfaction levels (YP = 98.5%, MP = 94.1%, P = .370) were similar. There were no graft ruptures or reoperations.
In an Asian, predominantly male population, the clinical outcomes of arthroscopic ACL reconstruction in YP and MP are equally good at 2-year follow-up. MP can benefit as much as younger patients from ACL reconstruction in terms of restoration of knee function and return to preinjury activity level, are equally satisfied with outcomes, and should not be excluded from surgery on the basis of age alone.
Level III, retrospective comparative study.
比较年轻和中年亚洲人群关节镜前交叉韧带（ACL）重建的临床结果。
使用三级机构 ACL 注册处前瞻性收集的数据进行回顾性研究。纳入 2008 年至 2014 年间由同一位外科医生行初次关节镜 ACL 重建的所有 ACL 撕裂的亚洲患者，且均至少随访 2 年。排除既往膝关节手术或多韧带膝关节损伤的患者。将患者分为两组：年轻患者（YP）（年龄<30 岁）和中年患者（MP）（年龄>40 岁）。比较两组患者术前、术后 6 个月、1 年和 2 年的人口统计学资料、膝关节活动度、前向松弛度、Tegner 水平、Lysholm 和国际膝关节文献委员会（International Knee Documentation Committee，IKDC）评分、重返术前活动水平的能力以及患者满意度。
YP（n=84）和 MP（n=22）在平均年龄（YP=23.1 岁，范围 18-29 岁；MP=46.4 岁，范围 41-59 岁，P<0.001）、术前 Tegner 水平（YP=7.4，MP=6.4，P=0.005）和术前 Lysholm 评分（YP=65.3，MP=53.0，P=0.034）方面存在差异。半月板和软骨损伤的发生率相似。术后 2 年，两组患者的膝关节活动度和前向松弛度均相似。Tegner 评分不同（YP=6.3，MP=5.2，P=0.028），但重返术前 Tegner 水平的患者比例（YP=45.2%，MP=46.9%，P=0.812）、Lysholm 评分（YP=92.5，MP=93.8，P=0.794）、IKDC A/B 评分（YP=77.4%，MP=81.8%，P=0.777）和患者满意度（YP=98.5%，MP=94.1%，P=0.370）相似。无移植物断裂或再次手术。
在亚洲人群中（主要为男性），YP 和 MP 患者的关节镜 ACL 重建的临床结果在 2 年随访时同样良好。MP 可以像年轻患者一样从 ACL 重建中受益，在膝关节功能恢复和重返术前活动水平方面，他们对结果同样满意，不应该仅因年龄而被排除在手术之外。
III 级，回顾性比较研究。
